| Date of Action |
Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
|---|---|
| Feb 10, 2014 |
print number 2637a |
| Feb 10, 2014 |
amend and recommit to insurance |
| Jan 08, 2014 |
referred to insurance |
| Jan 23, 2013 |
referred to insurance |
Senate Bill S2637A
2013-2014 Legislative Session
Sponsored By
(D, WF) 21st Senate District
Archive: Last Bill Status - In Senate Committee Insurance Committee
Actions
Bill Amendments
2013-S2637 - Details
2013-S2637 - Summary
Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery and such physician's services shall not be covered by their insurance policy; such services must be covered if the insured person does not receive notification prior to such services or procedure.
2013-S2637 - Sponsor Memo
BILL NUMBER:S2637
TITLE OF BILL:
An act
to amend the insurance law, in relation to requiring notification to
insured persons
that an out-of-network physician may be used in their
procedure, test or surgery
PURPOSE OR GENERAL IDEA OF BILL:
To provide notice to patients that services provided may not be
covered by health insurance.
SUMMARY OF SPECIFIC PROVISIONS:
Section 3216 of the insurance law is amended by adding a new
subsection (m); and Section 3221 of the insurance law is amended by
adding a new subsection (s).
JUSTIFICATION:
Very often out of network providers perform services to patients
without Patients being made aware that they will be responsible for
payment for such services as the provider is not a participating
physician of the patient's insurance carrier. An example would be an
anesthesiologist who meets a patient shortly before surgery. If the
anesthesiologist is not a participating provider, the patient will
2013-S2637 - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
2637
2013-2014 Regular Sessions
I N S E N A T E
January 23, 2013
___________
Introduced by Sen. PARKER -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring notification
to insured persons that an out-of-network physician may be used in
their procedure, test or surgery
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 3216 of the insurance law is amended by adding a
new subsection (m) to read as follows:
(M) (1) EVERY PERSON INSURED UNDER A POLICY OF ACCIDENT AND HEALTH
INSURANCE DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE SHALL BE ENTI-
TLED TO NOTIFICATION FROM THE BILLING ENTITY PRIOR TO THE PROCEDURE,
TEST OR SURGERY, THAT AN OUT-OF-NETWORK PHYSICIAN MAY BE USED IN SUCH
PROCEDURE, TEST OR SURGERY AND SUCH PHYSICIAN'S SERVICES SHALL NOT BE
COVERED BY THEIR INSURANCE POLICY.
(2) THE PATIENT COSTS OF OUT-OF-NETWORK PHYSICIAN SERVICES SHALL BE
COVERED BY THE INSURANCE POLICY OF AN INSURED PERSON IF HE OR SHE HAS
NOT RECEIVED NOTIFICATION OF SUCH SITUATIONS, PRIOR TO THE HEALTH
SERVICE OR PROCEDURE, AS PRESCRIBED IN PARAGRAPH ONE OF THIS SUBSECTION.
S 2. Section 3221 of the insurance law is amended by adding a new
subsection (s) to read as follows:
(S) (1) EVERY PERSON INSURED UNDER A POLICY OF ACCIDENT AND HEALTH
INSURANCE DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE SHALL BE ENTI-
TLED TO NOTIFICATION FROM THE BILLING ENTITY PRIOR TO THE PROCEDURE,
TEST OR SURGERY, THAT AN OUT-OF-NETWORK PHYSICIAN MAY BE USED IN SUCH
PROCEDURE, TEST OR SURGERY AND SUCH PHYSICIAN'S SERVICES SHALL NOT BE
COVERED BY THEIR INSURANCE POLICY.
(2) THE PATIENT COSTS OF OUT-OF-NETWORK PHYSICIAN SERVICES SHALL BE
COVERED BY THE INSURANCE POLICY OF AN INSURED PERSON IF HE OR SHE HAS
NOT RECEIVED NOTIFICATION OF SUCH SITUATIONS, PRIOR TO THE HEALTH
SERVICE OR PROCEDURE, AS PRESCRIBED IN PARAGRAPH ONE OF THIS SUBSECTION.
S 3. This act shall take effect immediately.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
2013-S2637A (ACTIVE) - Details
2013-S2637A (ACTIVE) - Summary
Requires notification to insureds that an out-of-network physician may be used in their procedure, test or surgery and such physician's services shall not be covered by their insurance policy; such services must be covered if the insured person does not receive notification prior to such services or procedure.
2013-S2637A (ACTIVE) - Sponsor Memo
BILL NUMBER:S2637A
TITLE OF BILL: An act to amend the insurance law, in relation to
requiring notification to insured persons that an out-of-network
physician may be used in their procedure, test or surgery
PURPOSE OR GENERAL IDEA OF BILL:
To provide notice to patients that services provided may not be
covered by health insurance.
SUMMARY OF SPECIFIC PROVISIONS:
Section 3216 of the insurance law is amended by adding a new
subsection (n); and Section 3221 of the insurance law is amended by
adding anew subsection (t).
JUSTIFICATION:
Very often out of network providers perform services to patients
without Patients being made aware that they will be responsible for
payment for such services as the provider is not a participating
physician of the patient's insurance carrier. An example would be an
anesthesiologist who meets a patient shortly before surgery. If the
anesthesiologist is not a participating provider, the patient will
receive a bill and be responsible for payment. Had the
2013-S2637A (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K
________________________________________________________________________
2637--A
2013-2014 Regular Sessions
I N S E N A T E
January 23, 2013
___________
Introduced by Sen. PARKER -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance -- recommitted
to the Committee on Insurance in accordance with Senate Rule 6, sec. 8
-- committee discharged, bill amended, ordered reprinted as amended
and recommitted to said committee
AN ACT to amend the insurance law, in relation to requiring notification
to insured persons that an out-of-network physician may be used in
their procedure, test or surgery
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 3216 of the insurance law is amended by adding a
new subsection (n) to read as follows:
(N) (1) EVERY PERSON INSURED UNDER A POLICY OF ACCIDENT AND HEALTH
INSURANCE DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE SHALL BE ENTI-
TLED TO NOTIFICATION FROM THE BILLING ENTITY PRIOR TO THE PROCEDURE,
TEST OR SURGERY, THAT AN OUT-OF-NETWORK PHYSICIAN MAY BE USED IN SUCH
PROCEDURE, TEST OR SURGERY AND SUCH PHYSICIAN'S SERVICES SHALL NOT BE
COVERED BY THEIR INSURANCE POLICY.
(2) THE PATIENT COSTS OF OUT-OF-NETWORK PHYSICIAN SERVICES SHALL BE
COVERED BY THE INSURANCE POLICY OF AN INSURED PERSON IF HE OR SHE HAS
NOT RECEIVED NOTIFICATION OF SUCH SITUATIONS, PRIOR TO THE HEALTH
SERVICE OR PROCEDURE, AS PRESCRIBED IN PARAGRAPH ONE OF THIS SUBSECTION.
S 2. Section 3221 of the insurance law is amended by adding a new
subsection (t) to read as follows:
(T) (1) EVERY PERSON INSURED UNDER A POLICY OF ACCIDENT AND HEALTH
INSURANCE DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE SHALL BE ENTI-
TLED TO NOTIFICATION FROM THE BILLING ENTITY PRIOR TO THE PROCEDURE,
TEST OR SURGERY, THAT AN OUT-OF-NETWORK PHYSICIAN MAY BE USED IN SUCH
PROCEDURE, TEST OR SURGERY AND SUCH PHYSICIAN'S SERVICES SHALL NOT BE
COVERED BY THEIR INSURANCE POLICY.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02013-02-4
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